2. Drug Misuse and Dependency

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Presentation transcript:

2. Drug Misuse and Dependency April 2016

What is substance misuse/dependency What is substance misuse/dependency? Can one become dependent on legal highs?

Substance Use Disorders -Classification diagnostic statistical manual DSM V (USA) or International Classification of Diseases and Health Problems (ICD-10) ICD10 (Europe): Recurrent use resulting in a failure to fulfil major obligations at work, school, or home Legal problems resulting from recurrent use Continued use despite significant social or interpersonal problems caused by the substance use Recurrent use in situations which are physically hazardous (e.g. driving while intoxicated) http://www.dsm5.org/Documents/Substance%20Use%20Disorder%20Fact%20Sheet.pdf http://www.who.int/substance_abuse/terminology/ICD10ClinicalDiagnosis.pdf

DSM IV Substance Dependence: Substance abuse Increase in tolerance Withdrawal symptoms Compulsion to use

Withdrawal Abrupt discontinuation or decrease in intake of medications or recreational drugs Common withdrawal problems with some antidepressants, psychostimulants, benzodiazepines and alcohol

Withdrawal effects Anxiety Irritability Drug craving Cramps Hypo-locomotion Anhedonia Depression?

Cognitive deficits While under the influence After chronic use Loss of concentration Dissociation Psychoses After chronic use Memory loss Executive function

Evidence for legal highs showing addictive and/or withdrawal effects?

Literature Erik W. Gunderson, et al (2012)“Spice” and “K2” Herbal Highs: A Case Series and Systematic Review of the Clinical Effects and Biopsychosocial Implications of Synthetic Cannabinoid Use in Humans The American Journal on Addictions 21 (4) 320-326. DOI: 10.1111/j.1521-0391.2012.00240.x Lally J, Hallaghan B et al. Prevalence study of head shop drug usage in mental health. B J Psych. 2013. doi: 10.1192/pb.bp.111.038315. 7. The rise and rise of legal highs http://www.menshealth.co.uk/healthy/addictions/the-rise-and-rise-of-legal-highs Turnbull A ( 2015) Independent Nurse, The low profile of legal highs http://www.independentnurse.co.uk/news/the-low-profile-of-legal-highs/110920/

Literature Psychiatria Danubina, 2011; Vol. 23, Suppl. 1, pp 32–34 Conference paper UNUSUAL PRESENTATION OF A PATIENT WITH GBL WITHDRAWL: A CASE REPORT Gursharan Lal Kashyap & Ashok G. Patel South Essex Partnership University Foundation Trust Calnwood Court Luton Bedfordshire, UK http://www.hdbp.org/psychiatria_danubina/pdf/dnb_vol23_sup/dnb_vol23_sup_32.pdf Royal College of Psychiatrists (2014)One new drug a week Why novel psychoactive substances and club drugs need a different response from UK treatment providers p8 table listing effects http://www.rcpsych.ac.uk/pdf/FR%20AP%2002_Sept2014.pdf Winder ,G.S. et al (2103)Are “Bath Salts” the next generation of stimulant abuse? Journal of Substance Abuse Treatment 44(1) p 42–45 doi:10.1016/j.jsat.2012.02.003